介入开通慢性闭塞颈动脉的临床应用价值及对认知功能的影响  

Clinical application value of endovascular treatment for chronic carotid artery occlusion and its influence on cognitive function

作　　者：张磊[1] 鲍丽[2] 吴祥波 梅斌[1] 孙冬[1] 李华钢[1] 么冬爱[2] ZHANG Lei;BAO Li;WU Xiang-bo(Department of Neurology,Zhongnan Hospital,Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院神经内科,武汉430071 [2]武汉大学中南医院体检中心,武汉430071 [3]湖北省黄冈市中心医院神经科,湖北438000

出　　处：《放射学实践》2022年第9期1155-1159,共5页Radiologic Practice

基　　金：武汉大学中南医院科技创新培育基金项目(CXPY2020040)。

摘　　要：目的:探讨介入开通慢性闭塞颈动脉的有效性和安全性及其对认知功能的影响。方法:前瞻性搜集2018年8月至2019年7月接受介入开通慢性闭塞颈动脉患者组成研究队列,分析慢性颈动脉闭塞患者的临床特点、手术方式及其有无新的缺血性事件发生,比较基线MoCA评分和术后3个月左右的MoCA评分。结果:本研究共纳入12例患者,其中男10例,女2例,年龄28~71岁,中位年龄58岁。10例患者成功开通闭塞血管,2例患者开通失败。术后3个月左右的MoCA评分高于术前,差异有统计学意义(P=0.004),主要体现在视空间与执行功能(P=0.008)、延迟回忆(P=0.004)方面有明显改善。结论:介入开通慢性闭塞颈动脉是有效和安全的,其对改善认知功能有着积极作用。Objective:To investigate the efficacy and safety of endovascular treatment for chronic carotid artery occlusion(CCAO)and its effect on cognitive function.Methods:Patients who received endovascular treatment for CCAO were prospectively recruited from August 2018 to July 2019.The clinical characteristics,surgical approach,and occurrence of new ischemic events of CCAO were analyzed,and baseline Montreal Cognitive Assessment(MoCA)was compared with MoCA three months after surgery.Results:A total of 12 patients with CCAO were enrolled in this study,including ten men and two women,with a median age of 58 years(range,28~71 years).The occluded vessels were successfully opened in 10 patients and failed in 2 patients.MoCA scores about three months after surgery were higher than those before surgery,and the difference was statistically significant(P=0.004),which was mainly reflected in the significant improvement in visuospatial and executive function(P=0.008)and delayed recall(P=0.004).Conclusion:Endovascular treatment of CCAO is effective and safe,and it has a positive effect on improving cognitive function.

关 键 词：慢性颈动脉闭塞 血管内治疗 认知功能 卒中 

分 类 号：R543.5[医药卫生—心血管疾病] R814.43[医药卫生—内科学]